FORM 1023-EZ for SALEM-RYAL SENIOR CITIZENS NUTRITION CENTER INC

Field Data
EIN 81-2719204
Case Number EO-2016179-000296
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SALEM-RYAL SENIOR CITIZENS NUTRITION CENTER INC
Organization’s Mailing Address 113092 S 3980 RD
City HENRYETTA
State OK
ZIP 74437
Accounting period End 6
Primary contact name BEVERLY KUYKENDALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JACKY FOWLER
CHAIRMAN
RT 2 BOX 452
HENRYETTA OK 74437

Officer/Director/Trustee Two

SARAH KALER
DIRECTOR
RT 2 BOX 384
HENRYETTA OK 74437

Officer/Director/Trustee Three

MIKE ROWE
CO-CHAIRMAN
RT 2 BOX 418D
HENRYETTA OK 74437

Officer/Director/Trustee Four

DALE DICKEY
DIRECTOR
PO BOX 457
HENRYETTA OK 74437

Officer/Director/Trustee Five

BEVERLY KUYKENDALL
SECRETARY/TREASURER
113231 S 3960 RD
HENRYETTA OK 74437

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/12/2016
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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